How to talk about sex—with your aging loved ones

Do you remember being on the receiving end of the “sex talk” from your parents? Or have you been trying to block it out all these years like the rest of us?

If you thought that was awkward, then imagine flipping the script: sitting your parents down and giving the talk right back to them.

Uncomfortable? Yes, but it gives you perspective on where your parent or guardian was coming from all those years ago—a place of love, concern and straight-up responsibility. So if you find yourself feeling the same concern that your aged loved one once had for you, then you must take on the same responsibility and discuss the issue: sex.

Fact: Senior citizens are ‘doing it’

It’s a common misconception that “old people are asexual” and that the number of children a person has equals their total number of lifetime sexual encounters. If you can identify with this, then here’s something to mull over (but not too hard): 57 percent of men and 52 percent of women 70 years old and up are sexually active.

“Sexuality, intimacy and companionship does not grow grey and old,” said Dr. Nidhi Gulati, a family medicine physician at Augusta University Health and medical director of the Georgia War Veterans Nursing Home. “It spans a lifetime, and in reality, your aging loved one likely had a full, sexually active life.”

A number of factors contribute to the increasing rate of sexual activity among senior citizens.

The aging population has become more open in this day and age as sexuality and senior dating have become more acceptable.

The primary motivator to use a condom—fear of getting pregnant—doesn’t exist in the aging population, because pregnancy isn’t possible.

They’re living longer and more independently—perhaps in community-living scenarios.

“Many different sexual opportunities can occur within independent and community living scenarios,” Gulati said. “What happens there is that there’s a social scene of more readily available partners.”

Add in the increased use of Viagra and the historical lack of sexual education in schools (also contributing to less condom use), and there you have it: an unfortunate marked increase in sexually transmitted infections (STIs).

When do I intervene?

Again, sex is normal, but it’s important to know when a normal human instinct compromises the health and well-being of your aging loved one or others. Start by knowing your loved one’s decision making capacity. The involved elder must also decipher if they are aware of the risks of engaging in sexual activity—and the only way to assess this is through having a conversation.

Here’s a brief guide for advocating for your aging loved one based on his or her decision-making capacity:

Decision-making capacity

Caregiver response

Has full decision-making capacity + aware of risks

Maintain awareness of their decision-making capacity and romantic relationships, and keep lines of communication open

Does not have full decision-making capacity

Question if they are being physically or psychologically coerced to engage in sexual activity

If your aging loved one is in a supervised living situation, partner with his or her health care team

Also, if your aging loved one’s verbal, physical or visual display of sexuality has fallen outside the bounds of social norms, this could indicate that your loved one needs your help.

Gulati recommends taking advantage of every opportunity to discuss the topic, using your own understanding of the person—from their personality and communication style to their living situation—to determine how to communicate with them.

But she cautions: “Don’t impose or be controlling. It’s important to realize that the roles are not reversed—you as your aging loved one’s child or grandchild aren’t the parent or grandparent now.”

What can I do?

“To discuss delicate topics, first ask if you can engage in the topic, normalize it, and then stress confidentiality,” Gulati said. “You should have an accepting attitude and don’t assume; then begin to discuss safe sex and counsel.”

Here are a few additional tips from Gulati for advocating for the health and wellbeing of your aging loved one:

Listen without judgment

Offer support

Subtly redirect sexual behaviors and conversations to those that are non-sexual

Seek counsel from a geriatric medicine specialist

Are you seeing sexually aggressive or hyper-sexuality issues in your aging loved one? To find a doctor who specializes in geriatric medicine or schedule an appointment at Augusta University Health, visit augustahealth.org, or call 706-721-2273 (CARE).

About the author

Augusta University Health

Based in Augusta, Georgia, Augusta University Health is a world-class health care network, offering the most comprehensive primary, specialty and subspecialty care in the region. Augusta University Health provides skilled, compassionate care to its patients, conducts leading-edge clinical research and fosters the medical education and training of tomorrow’s health care practitioners. Augusta University Health is a not-for-profit corporation that manages the clinical operations associated with Augusta University.

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